Trajectories and correlates of mental health among urban, school-age children during the COVID-19 pandemic: a longitudinal study.

BACKGROUND: The COVID-19 pandemic posed numerous obstacles to psychosocial wellbeing for children. We conducted a longitudinal study to evaluate child mental health and social risks during the pandemic. METHODS: Participants were 172 caregivers of children aged 6-11 years old who attended well child visits within 6 months before pandemic onset at an urban safety net hospital in the US. Prepandemic data was extracted from the electronic medical record, and surveys were administered at three time points between August 2020 and July 2021. We measured mental health symptoms with the Pediatric Symptom Checklist-17, social risks (e.g., food and housing insecurity) with the THRIVE questionnaire, and school modality (in-person, hybrid, remote). RESULTS: Compared to pre-pandemic, children had significantly higher PSC-17 total scores (overall mental health symptoms) and THRIVE total scores (total burden of social risks) at all three mid-pandemic waves. Using longitudinal mixed models accounting for time, social risks, and school modality, both social risks (B = 0.37, SE = 0.14, p < 0.01) and school modality were significantly associated with PSC-17 scores (B = - 1.95, SE = 0.63, p < 0.01). Children attending in-person school had fewer mental health symptoms than those attending remote or hybrid school. CONCLUSION: Mental health symptoms and social risks remained significantly higher fifteen months after the onset of the COVID-19 pandemic compared to prepandemic. In-person attendance at school appeared protective against persistently elevated mental health symptoms.

Antimicrobial Properties and Substantivity of Gentamicin, Amoxicillin and Metronidazole (GAM) Antibiotic Solution with Chitosan as a Root Canal Irrigant - A Preliminary Study.

Irrigation is one of the steps that is very crucial in a high-quality endodontic treatment. Hence, irrigant with good substantivity is essential which must not only be effective for the dissolution of the organic tissues but also effectively eliminate bacterial contamination. The aim of the study was to investigate and compare the antimicrobial efficacy of gentamicin, amoxicillin, and metronidazole (GAM) antibiotic solution, chitosan and their combination (GAMC), and analyze their sustained release property. Mueller-Hinton agar medium was inoculated with E. faecalis. The medicaments were then poured at the center of the plate in the prepared wells and incubated at 37°C. Antibacterial property of each medicament was evaluated by measuring the diameter of the zone of inhibition at the end of 48 hours. The substantivity of GAM antibiotic solution and the GAMC was checked using an ultraviolet spectrophotometer. The GAMC demonstrated the strongest antimicrobial activity and good sustained-release properties. Distilled water showed no activity, and chlorhexidine acted as the positive control. Conclusion: The combination of gentamicin, amoxicillin, and metronidazole (GAM) solution with chitosan (GAMC) can be used as an alternative intracanal irrigant as it was found to be a potent antibacterial agent.

A Clinico-Histopathological Study of Lupus Vulgaris at a Tertiary Care Centre.

Background and objectives Lupus vulgaris is a chronic, progressive, paucibacillary form of cutaneous tuberculosis that occurs in persons with moderate to high immunity. Due to its varied clinical presentation, it can masquerade as different dermatological conditions. This study describes the demographic patterns and varieties of clinical manifestations that can be possible in this curable illness. Methods This study was conducted over two years and included 19 patients with histopathologically confirmed lupus vulgaris in Odisha, India. Demographic data, clinical features, and response to treatment are presented. Results Thirteen cases (68.4%) were seen in adults and six (31.6%) in pediatric patients. The lower limbs were the more affected (n=10), followed by the upper limb (6), the face (2), and the chest (1). All but one patient had plaque-type lesions. On histopathology, all showed a tuberculoid granuloma with no demonstration of acid-fast bacilli with Ziehl-Neelsen staining. Conclusion In the present study, the incidence was mostly observed in the young and higher activity age groups (5-40 years). Plaque-type lesions were most commonly encountered. In histopathology, all the cases had tubercular granuloma-type lesions without any incidence of malignant transformations. All the patients responded well to conventional multi-drug anti-tubercular chemotherapeutic regimens.

Introducing a novel histopathological scoring system to assess disease activity and chronicity in cutaneous lichen planus: A proposal.

BACKGROUND: Lichen planus (LP) is a chronic inflammatory disorder caused by an autoimmune attack by cytotoxic T-cells. The clinical course is variable, with episodes of remission and exacerbation. A clinicopathological scoring system for cutaneous LP is not available for effectively assessing disease severity and monitoring treatment response. This study was designed with the aim of proposing an objective and reproducible scoring system, comprising histopathological features of active and chronic disease, and to correlate these scores with clinical morphology groups. METHODOLOGY: This is a retrospective study of 200 cases of cutaneous LP, which were categorized into five clinical groups (I-V) at the time of biopsy. The corresponding histopathological feature was assigned a score based on feature of active and chronic disease. Individual scores were summated to calculate a histopathological index (index [AI] and chronicity index [CI]). The comparison of indices between various clinical groups was performed by Mann-Whitney U test. RESULTS: The median AI was lowest (1) for post-inflammatory hyperpigmentation (clinical group I) and highest (7) for the bullous group (clinical group IV). The median CI (7) was highest for the scarring group (clinical group V). The difference between median AI of clinical group I (post-inflammatory hyperpigmentation) and rest of the groups (clinical groups II, III, IV, and V) was statistically significant (p value <0.05). CONCLUSION: We present this clinico-histopathological scoring system as a reliable and facile method of assessing the activity and severity of LP.

A Cross-Sectional Assessment of Quantitative Epidermal Melanin and Erythema Indices among North Indians.

Background: Remarkable diversity of skin tones among Indians ranging from pale pinkish to dark brown appears to be an ideal choice for the assessment of skin pigment variation. Aim: The present study was designed to assess the variation observed in melanin and erythema indices among north Indians. Material and Methods: Skin reflectance data (n = 574) was collected from six diverse populations of north India using DermaSpectrometer (DSM II ColorMeter) followed by statistical analysis to investigate the impact of geographical location and gender on constitutive skin pigmentation. Results: The melanin index (MI) varied between 17.93 and 56.92 (Mean (M) = 35.80 ± 6.26) whereas the erythema index (EI) varied between 4.92 and 18.82 (M = 10.48 ± 2.68). MI and EI of females were found to be significantly lower than males (P < 0.001). Geographical location exhibited a significant association with MI and EI (P < 0.001). Furthermore, we have noted a positive correlation between MI and EI (P < 0.001). Conclusion: The study has refined our understanding of skin pigmentation variation among north Indians in terms of significant association with geographical location {MI: F (5,568) = 31.07, P < 0.001; EI: F (5,568) = 73.37, P < 0.001} and gender {MI: t (386) = -4.06, P < 0.001; EI: t (386) = -11.96, P < 0.001} and rendered opportunities for further studies.

Infections Associated Hemophagocytosis-Secondary HLH Mimics in Children!"

Infection-associated hemophagocytosis is a diagnostic challenge. The varied presentation makes timely diagnosis difficult. We report two cases with unusual presentation of well-established secondary triggers for hemophagocytic lymphohistiocytosis.

Sex-specific variations in global DNA methylation levels with age: a population-based exploratory study from North India.

Purpose: Aging is one of the most important risk factors for a number of human diseases. Epigenetic alterations, including changes in DNA methylation patterns, have been reported to be one of the hallmarks of aging. Being a malleable process, the role of site-specific DNA methylation in aging is being extensively investigated; however, much less attention has been given to alterations in global DNA methylation with aging at the population level. The present study aims to explore overall and sex-specific variations in global DNA methylation patterns with age. Methods: A total of 1,127 adult individuals (792 females) aged 30-75 years belonging to Haryana, North India, were recruited. Socio-demographic data was collected using a pretested interview schedule. Global DNA methylation analysis, of peripheral blood leucocyte (PBL) DNA, was performed using the ELISA-based colorimetric technique. Results: Though the overall correlation analysis revealed a weak inverse trend between global DNA methylation and age, the adjusted regression model showed no significant association between global DNA methylation and age. In age-stratified analysis, global DNA methylation levels were found to be fairly stable until 60 years of age, followed by a decline in the above-60 age group. Further, no significant difference in DNA patterns methylation pattern was observed between males and females. Conclusion: Overall, the study suggests a lack of association between global DNA methylation and age, especially until 60 years of age, and a similar DNA methylation pattern between males and females with respect to age.

Investigating the morphology and genetics of scalp and facial hair characteristics for phenotype prediction.

Microscopic traits and ultrastructure of hair such as cross-sectional shape, pigmentation, curvature, and internal structure help determine the level of variations between and across human populations. Apart from cosmetics and anthropological applications, such as determining species, somatic origin (body area), and biogeographic ancestry, the evidential value of hair has increased with rapid progression in the area of forensic DNA phenotyping (FDP). Individuals differ in the features of their scalp hair (greying, shape, colour, balding, thickness, and density) and facial hair (eyebrow thickness, monobrow, and beard thickness) features. Scalp and facial hair characteristics are genetically controlled and lead to visible inter-individual variations within and among populations of various ethnic origins. Hence, these characteristics can be exploited and made more inclusive in FDP, thereby leading to more comprehensive, accurate, and robust prediction models for forensic purposes. The present article focuses on understanding the genetics of scalp and facial hair characteristics with the goal to develop a more inclusive approach to better understand hair biology by integrating hair microscopy with genetics for genotype-phenotype correlation research.

Observations of Atmospheric Tides in the Middle and Upper Atmosphere of Mars From MAVEN and MRO.

Variability in the Martian upper atmosphere is strongly linked to the lower atmosphere and much of it can be attributed to vertical wave propagation. Atmospheric tides in particular are a well-known phenomenon in the Martian atmosphere that play a key role in the transport of energy as they propagate to higher altitudes. Previous theoretical predictions and observations suggest that tides producing wavenumber-2 and wavenumber-3 patterns are strongest in a fixed local time at high altitudes, however, the energy they carry and the region of deposition are not well characterized. Given the availability of atmospheric observations from several spacecraft at the same time, in this paper, the nature and behavior of tides are studied concurrently at several altitudes. Here, six intervals are identified focused at fixed low latitudes utilizing simultaneous observations of the middle and upper atmosphere from in situ and remote sensing instruments on different spacecraft. In the middle atmosphere, strong wavenumber-2 signatures are identified in the intervals north of the equator whereas, in the south, wavenumber-3 signatures are strongest. Wave signatures observed in the upper atmosphere seem to be dominated by a mix of wavenumbers-2 and -3. Seasonal variation is observed in the northern intervals, with very little interannual variability in all intervals considered. Estimates of energy based on dominant wavenumber amplitude suggest that most of the energy dissipates below ∼90 km. Furthermore, model sampled output captures the dominant wavenumbers observed in the middle atmosphere as well as the energy dissipation characteristics.

Efficacy of polyherbal formulations for prevention of COVID-19 infection in high-risk subjects: A randomized open-label controlled clinical trial.

COVID-19 is arguably the biggest health crisis the world has faced in the 21st century. Therefore, two of the polyherbal formulations, Infuza and Kulzam were assessed for the prevention of COVID-19 infection as a repurposed medication. Four hundred seven high-risk subjects were recruited in the present open-label randomized controlled clinical trial for eligibility. After assessment for eligibility, remaining 251 subjects were randomized to the test and control groups. Further, 52 high-risk subjects in Infuza, 51 in Kulzam, 51 in Infuza & Kulzam and 53 in control group completed the 14 days of intervention/assessment. The phenotyping of lymphocytes at baseline (0 day) and after 14 days of treatment was carried out by flow cytometry assays. A total of 15.09% high-risk subjects in control group turned positive as compared to only 7.69% in Infuza, 3.92% in Kulzam and 1.96% in Infuza & Kulzam groups. The rate of conversion to COVID-19 infection in Infuza & Kulzam group was minimal and statistically significant as compared to control group (p0.017). No significant changes in phenotype of lymphocytes (T, B, NK cells), absolute lymphocyte count and cytokine levels were found in study groups. However, there was a decreasing trend of hs-CRP level in high-risk subjects after intervention of polyherbal formulations for 14 days. The combination of Infuza and Kulzam may synergistically prevent COVID-19 infection in high-risk subjects of COVID-19.

Forensic DNA phenotyping: Inferring phenotypic traits from crime scene DNA.

INTRODUCTION: Forensic DNA Phenotyping (FDP) has provided better understanding of various phenotypic features (e.g., height, skin colour, eye colour, structure and shape of scalp hair, baldness, facial features etc.) and associated genetic variations. The current study was designed to investigate the genetic variants and their potential contribution towards accurate phenotype prediction systems. Short Tandem Repeat (STR) based DNA typing method can be uninformative or with little potential to solve a crime in absence of suspect DNA profile in the database. Forensic DNA Phenotyping (FDP), prediction of externally visible characteristics (EVCs) from the crime scene DNA would certainly provide a new dimension to personal identification. The aim of this review paper is to highlight the significance and future prospects of FDP. RESULTS: A comprehensive literature review was conducted using PubMed and similar e-databases with keywords from two main components-phenotype and the associated genetic variants. To ensure a thorough literature review, searches were extended using the snowballing technique from reference lists. Key data extracted were type of study, sample characteristics (sample size, age, geographical location and ancestry), details of SNPs studied and prediction accuracies. CONCLUSION: Phenotyping tools based on genotyping and statistical analysis for the prediction of human pigmentation are propitious in solving cold cases. This indicates the inevitability of future studies for the identification of new genetic markers for accurate prediction of phenotype or EVCs via genome-wide association study (GWAS) in diverse global populations.

Molecular electronics sensors on a scalable semiconductor chip: A platform for single-molecule measurement of binding kinetics and enzyme activity.

For nearly 50 years, the vision of using single molecules in circuits has been seen as providing the ultimate miniaturization of electronic chips. An advanced example of such a molecular electronics chip is presented here, with the important distinction that the molecular circuit elements play the role of general-purpose single-molecule sensors. The device consists of a semiconductor chip with a scalable array architecture. Each array element contains a synthetic molecular wire assembled to span nanoelectrodes in a current monitoring circuit. A central conjugation site is used to attach a single probe molecule that defines the target of the sensor. The chip digitizes the resulting picoamp-scale current-versus-time readout from each sensor element of the array at a rate of 1,000 frames per second. This provides detailed electrical signatures of the single-molecule interactions between the probe and targets present in a solution-phase test sample. This platform is used to measure the interaction kinetics of single molecules, without the use of labels, in a massively parallel fashion. To demonstrate broad applicability, examples are shown for probe molecule binding, including DNA oligos, aptamers, antibodies, and antigens, and the activity of enzymes relevant to diagnostics and sequencing, including a CRISPR/Cas enzyme binding a target DNA, and a DNA polymerase enzyme incorporating nucleotides as it copies a DNA template. All of these applications are accomplished with high sensitivity and resolution, on a manufacturable, scalable, all-electronic semiconductor chip device, thereby bringing the power of modern chips to these diverse areas of biosensing.

CRISPR-Cas enzymes: The toolkit revolutionizing diagnostics.

The programmable nature of sequence-specific targeting by CRISPR-Cas nucleases has revolutionized a wide range of genomic applications and is now emerging as a method for nucleic acid detection. We explore how the diversity of CRISPR systems and their fundamental mechanisms have given rise to a wave of new methods for target recognition and readout. These cross-disciplinary advances found at the intersection of CRISPR biology and engineering have led to the ability to rapidly generate solutions for emerging global challenges like the COVID-19 pandemic. We further discuss the advances and potential for CRISPR-based detection to have an impact across a continuum of diagnostic applications.

Changes in psychosocial functioning among urban, school-age children during the COVID-19 pandemic.

BACKGROUND: There is concern about the effect of the COVID-19 pandemic on psychosocial functioning among school-age children, who have faced unusual stressors during this time. Our goal was to assess mental health symptoms and social risks during COVID-19, compared to before the pandemic, for urban, racial and ethnic minority school-age children, and investigate the relationship between mental health and social risks. METHODS: We conducted a cohort study from September 2019 until January 2021 of children age 5-11 years old recruited from an urban safety net hospital-based pediatric primary care practice. We measured emotional and behavioral symptoms (including attention, internalizing, and externalizing symptoms) before and during the pandemic with the Pediatric Symptom Checklist (PSC-17). We measured social risks (including food and housing insecurity) before and during the pandemic with the THRIVE screener. We measured additional mid-pandemic COVID-related stressors with items on school participation, screens/media use, illness exposure, and caregiver mental health. We compared pre- and mid-pandemic PSC-17 symptom scores across 4 domains (total, attention, internalizing, and externalizing) and used path analysis to examine the relationship between mental health and social risks pre- and mid-pandemic. RESULTS: Caregivers of 168 children (54% non-Hispanic Black, 29% Hispanic, and 22% non-English speaking) completed the study. Children had significantly higher levels of emotional and behavioral symptoms midpandemic- vs. pre-pandemic in all domains. Significantly more children had a positive PSC-17 total score (18% vs. 8%, p < 0.01) and internalizing (depression and anxiety) score (18% vs. 5%, p < 0.001) during the pandemic vs. before, indicating clinical concerns in these areas. Caregivers reported significantly more social risks during vs. before the pandemic (p < 0.001). Mental health symptoms significantly correlated with number of social risks before the pandemic, but not during the pandemic. Less school assignment completion, increased screen time, and caregiver depression were all significantly associated with worse mid-pandemic mental health in children. CONCLUSION: The COVID-19 pandemic has led to a dramatic increase in depression/anxiety problems and social risks among urban, racial and ethnic minority school-age children compared to before the pandemic. More research is needed to understand if these changes will persist.

Acromioclavicular joint tuberculosis: A report of two cases.

Acromioclavicular joint tuberculosis is an extremely rare presentation with only 16 cases reported so far and has a relatively high propensity to be misdiagnosed. India being a tuberculosis endemic region accounts for almost 27% of cases worldwide (global index of 2018 was 10 million). With a higher index of suspicion an earlier diagnosis can be made. We report two patients of AC joint tuberculosis, treated with multidrug chemotherapy resulting in a good functional outcome.

A Pilot Study to Compare Therapeutic Efficacy and Safety of Combined Treatment of Skin Microneedling and Depigmenting Cream versus Depigmenting Cream Alone in Facial Melasma at Tertiary Care Center.

BACKGROUND: Melasma is a commonly acquired, chronic, and relapsing disorder that results in symmetrical, brownish facial pigmentation. It is more common in women than in men, which generally starts between 20 and 40 years of age, and it can lead to considerable embarrassment and distress. Managing melasma is a difficult challenge that requires long-term treatment with a number of topical agents. Microneedling has been described as a new technique to enhance the drug's transdermal penetration, and has also been reported to result in sustained long-term improvement of recalcitrant melasma. AIM: The aim of this article was to compare the therapeutic efficacy and safety of combined treatment of skin microneedling and depigmenting cream versus depigmenting cream alone in the treatment of melasma. MATERIALS AND METHODS: A prospective study was conducted with a sample size of 40 patients, with twenty in each of the treatment arms; 20 patients were treated with combined skin needling and depigmenting cream and 20 with depigmenting cream alone. The outcome was evaluated periodically for up to 2 months using the modified Melasma Area and Severity Index (MASI) score. RESULTS: Significant reduction was observed in modified MASI score in the combined treatment, with P value <0.05. CONCLUSION: Combining microneedling with Kligman's regimen gives better results in melasma treatment compared to topical treatment alone.

Stochastic covid-19 model with fractional global and classical piecewise derivative.

Several methodologies have been advocated in the last decades with the aim to better understand behaviours displayed by some real-world problems. Among which, stochastics modelling and fractional modelling, fuzzy and others. These methodologies have been suggested to threat specific problems; however, It have been noticed that some problems exhibit different patterns as time passes by. Randomness and nonlocality can be combined to depict complex real-world behaviours. It has been observed that, covid-19 virus spread does not follow a single pattern; sometimes we obtained stochastic behaviours, another nonlocal behaviour and others. In this paper, we shall consider a covid-19 model with fractional stochastic behaviours. More precisely a covid-19 model, where the model considers nonlocalities and randomness is suggested. Then a comprehensive analysis of the model is conducted. Numerical simulations and illustrations are done to show the efficiency of the model.

Crescents in Kidney Biopsy - What Do They Imply? A Clinicopathologic Study of 40 Cases in a Tertiary Care Center.

INTRODUCTION: Crescents in glomeruli mean proliferation of parietal epithelium of Bowman's capsule with the presence of macrophages, lymphocytes, neutrophils, fibrin, and collagen. When crescents are present in >50% of nonfibrosed glomeruli, it is called crescentic glomerulonephritis (CGN). The presence of crescents is indicative of poorer prognosis. CGN can be pauci immune (PI), immune complex mediated (ICM), and anti-glomerular basement membrane (anti-GBM) disease. AIM: The aim was to study the clinicopathological spectrum of CGN over a period of 10 years in our center. MATERIALS AND METHODS: Forty kidney biopsies with the presence of crescents over a period of 5 years were retrieved retrospectively from the histopathology records of the department of pathology. The clinical history, laboratory parameters, histopathology report, and the direct immunofluorescence (DIF) findings were analyzed. RESULTS: Totally 40 cases had crescents on light microscopy. Out of these, 17 cases qualified for CGN. The mean age of the patients was 20 years. Nephritic syndrome was the most common presentation in these 17 cases. The mean creatinine level was 3.55 mg/dL. PI (7/17, 41.1%) was the most common category, followed by ICM (6/17, 35.2%) and anti-GBM (4/17, 23.5%). Out of the ICM, two cases were of IgA nephropathy with crescents and one of lupus with crescents. CONCLUSION: PI is the most common type of CGN. DIF examination is essential for exact categorization of CGN. Kidney biopsy in these cases can guide management and benefit patients with timely initiation of aggressive therapy.